title: Catheter closure of patent foramen ovale in patients with cryptogenic cerebrovascular accidents: initial experiences in Japan.
abstract: Although numerous studies have shown an association between a patent foramen ovale (PFO) and cryptogenic cerebrovascular accidents (CVA), there has been no definitive control study that demonstrated the benefit of percutaneous device closure of a PFO compared to medical therapy in patients with CVA. Additionally, few clinical data exist for Japanese patients in this field. We demonstrate the initial experiences in catheter closure of a PFO as secondary prevention of CVA in Japan. Catheter closure of a PFO was attempted in 7 patients who were diagnosed with cryptogenic CVA. Mean age at the procedure was 54 ± 19 years. The presence of spontaneous interatrial right-to-left shunts was demonstrated by transesophageal contrast echocardiography without Valsalva maneuver in all of the patients. Amplatzer Cribriform device (n = 4) or Amplatzer PFO Occluder (n = 3) was used for the procedure and was successfully deployed. Device-related complications were not observed at the time of the procedure or during the follow-up period (mean period of 16 ± 9 months). Catheter closure of a PFO could be safely performed with Amplatzer Cribriform or Amplatzer PFO Occluder. This procedure may contribute to prevention of recurrent cryptogenic CVA in Japanese patients.
authors.affiliation: Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Kijima
authors.forename: Teiji
authors.initials: T
authors.lastname: Akagi
authors.forename: Koji
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Manabu
authors.initials: M
authors.lastname: Taniguchi
authors.forename: Akira
authors.initials: A
authors.lastname: Ueoka
authors.forename: Kentaro
authors.initials: K
authors.lastname: Deguchi
authors.forename: Norihisa
authors.initials: N
authors.lastname: Toh
authors.forename: Hiroki
authors.initials: H
authors.lastname: Oe
authors.forename: Kengo
authors.initials: K
authors.lastname: Kusano
authors.forename: Shunji
authors.initials: S
authors.lastname: Sano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D054092:Foramen Ovale, Patent / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D055502:Secondary Prevention / Q000379:methods*; D055989:Septal Occluder Device; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome